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This is the discussion to "What Happened?" You may wish to review the case here. Ok, let's review the initial 12 Lead: Just about everyone picked up on the infero-posterior STEMI. Where it got interesting for me, was determining what the rhythm was! At first glance, the rhythm was for the most part regular (note […]

A 68 year old male, with no significant medical history, presents to the local ED (non-PCI) with chest pain. He had been doing some gardening, when he suddenly felt chest discomfort (8/10), non-radiating with diaphoresis. His wife drove him to the ED. Once there, he was given ASA and NTG, and the following ECG was […]

Here at the EMS 12-Lead Blog, we love case studies. We love to post them, you love to read them, and many of you love to comment on them. Not only on this blog, but on other very good blogs that are out there as well. I think it’s a great way to learn, and […]

Here is the discussion for the Snapshot Case: 32 year old male–Chest Discomfort. Sorry for the delay. If you recall, we have a young patient, a 32 year old male, with a heart rate too rapid to count. He is alert and oriented, and has a good pressure (126/70). He has been in the following […]

Here's a new snapshot case straight from the UK… We have a 32 year old male, normally fit with no history whatsoever. He has had a stressful week (personal issues), and decided maybe a 4 mile run might help. It didn't. When he returned home, he developed sudden onset of chest discomfort, and decided to […]

Here is an interesting case submitted by Adam Frederick, NREMT-Intermediate. As usual, some details have been changed to protect patient confidentiality. EMS is called to the local Urgent Care for a 63 year old male complaining of upper jaw pain related to "dental work". He had made two trips to the dentist this past week […]

This is the discussion for our "Snapshot" case, 58 year old male CC: Epigastric pain. You may wish to review the case before continuing. Thanks to all of you, we had a lot of great comments! Many of you had wished we had a rhythm strip to analyze… keep in mind, this 12 lead is a […]

From time to time, we may have an interesting ECG, but without enough information (including final diagnosis) or additional ECGs to make a full case study. In these instances, we will share the ECG and whatever information we have in our "Snapshot" series. As always, some information may be changed to protect patient confidentiality. Hope […]

This is the discussion to 63 year old female CC: Chest Pressure. You may wish to review the case. Also, you may wish to review the two part discussions about WPW here and here. Thanks to those who commented for some very insightful comments! Let's revisit one of the pre-conversion 12 Leads: We can see […]

Back in October, I was fortunate to attend the Resuscitation Academy in Seattle, WA. As many of you already know, the Academy is run by Seattle Medic One and King County EMS, with the goal of improving survival from out of hospital cardiac arrest. EMS directors, managers and medical directors convened for a three […]

Ken Grauer58 Year Old Male, Workout Worry@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24

Vince DiGiulioIs epinephrine harmful in cardiogenic shock?Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26

Ken Grauer, MDElectrocardiographically Silent High Lateral STEMI EquivalentHi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03

Eli58 Year Old Male, Workout WorryAnybody else see the possibility of a LBBB or A-Flutter? I'm not sure if this will make any difference with the treatments but im just trying to interpret it first because if there is a LBBB then it does not meat Sgarbossa criteria and if it is A-Flutter that could explain the hyper acute T's…
2018-07-20 21:29:21